Analysis of Candida auris candidemia cases in an Intensive Care Unit of a tertiary hospital

Rev Esp Anestesiol Reanim. 2021 Feb 23:S0034-9356(20)30293-0. doi: 10.1016/j.redar.2020.10.013. Online ahead of print.

ABSTRACT

Candida auris is a multi-resistant emerging fungus.

OBJECTIVES: To analyze the relationship between colonization by C.auris and the appearance of invasive candidiasis. Description of the sample of colonized patients, risk factors for colonization and/or infection, and calculation of mortality rates.

METHODOLOGY: Longitudinal observational study in an anesthesia intensive care unit in 2018.

RESULTS: 2130 patients were admitted. Surveillance studies were positive in 124 patients; 118 cases involved skin colonization and 52 were pharyngeal. Patients with a positive blood culture were identified. A statistically significant association was found between pharyngeal colonization and the appearance of a positive blood culture. There were significant differences between patients with a high Candida Score as a risk factor for candidemia. In total, 67% of pharyngeal carriers negativized at 1 month compared to 21% of cutaneous carriers, who negativized after 3-4 months. Of the patients with positive blood cultures, 70% of non-survivors received only monotherapy, although this difference was not statistically significant due to the small sample size.

CONCLUSIONS: The incidence of C.auris, a multi-resistant pathogen that is difficult to diagnose, treat and eradicate, is steadily increasing among critically ill patients. Its status as an emerging threat to global health calls for the urgent implementation of early in-hospital detection systems.

PMID:33637320 | DOI:10.1016/j.redar.2020.10.013